Harvesting buccal mucosal grafts

Contemporary Urology 2006; 18: 17-24.

An interesting and documented historical overview on the application of oral mucosa as surgical substitute material was reported in 1998 by Filipas et al. to give a link to other domains where the applications for urology have been developed. In 1993, El-Kasaby et al. reported the first experience with the use of buccal mucosa graft from the lower lip for treatment of penile and bulbar urethral strictures in adult patients without hypospadias. Since then buccal mucosa has become an increasingly popular graft tissue for anterior urethral reconstruction in 1 or 2-stage. Buccal mucosa has received increased attention in the urological literature because is easily harvested from the inner cheek or lower lip with a concealed donor site scar and readily available in all patients. Moreover, buccal mucosa is hairless and has a thick elastin rich epithelium making it tough and easy to handle, with a thin and highly vascular lamina propria that facilitates inosculation and imbibition. In our current experience, based on 8-10 urethroplasties in week, buccal mucosa has become the favorite substitute material for penile and bulbar urethroplasty. The ideal surgical technique for harvesting buccal mucosa would be simple, safe, reliable, and reproducible in the hands of any surgeon, as well based on sound anatomical principles and on adequate surgical instruments and steps. We believe that the techniques we present here fulfill all these criteria.